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Adjunctive tianeptine treatment for bipolar disorder: A 24-week randomized, placebo-controlled, maintenance trial. 2019
Márcia Kauer-Sant'Anna, and
Benicio N Frey, and
Adam Fijtman, and
Ana C Loredo-Souza, and
Aroldo A Dargél, and
Bianca Pfaffenseller, and
Bianca Wollenhaupt-Aguiar, and
Fernando K Gazalle, and
Gabriela D Colpo, and
Ives C Passos, and
Joana Bücker, and
Júlio C Walz, and
Karen Jansen, and
Mendes Ceresér, and
Kelen P Bürke Bridi, and
Lisiane Dos Santos Sória, and
Maurício Kunz, and
Michele Pinho, and
Natália S Kapczinski, and
Pedro D Goi, and
Pedro Vs Magalhães, and
Ramiro Reckziegel, and
Renan K Burque, and
Taiane de Azevedo Cardoso, and
Flávio Kapczinski
1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
The purpose of this study was to assess the efficacy and tolerability of tianeptine as an adjunctive maintenance treatment for bipolar depression. This is a multicenter double-blind randomized placebo-controlled maintenance trial of adjunctive tianeptine 37.5 mg/day. Participants ( n=161) had a Montgomery-Asberg Depression Rating Scale ⩾12 at entry. After eight weeks of open-label tianeptine treatment, those who responded to tianeptine ( n=69) were randomized to adjunctive tianeptine ( n=36) or placebo ( n=33) in addition to usual treatment. Kaplan-Meier estimates and the Mantel-Cox log-rank test were used to evaluate differences in time to intervention for a mood episode between the tianeptine and placebo groups. We also assessed overall functioning, biological rhythms, quality of life, rates of manic switch and serum brain-derived neurotrophic factor levels. There were no differences between adjunctive tianeptine or placebo regarding time to intervention or depression scores in the 24-week double-blind controlled phase. Patients in the tianeptine group showed better performance in the letter-number sequencing subtest from the Wechsler Adult Intelligence Scale at the endpoint ( p=0.014). Tianeptine was well tolerated and not associated with higher risk for manic switch compared to placebo. Tianeptine was not more effective than placebo in the maintenance treatment of bipolar depression. There is preliminary evidence suggesting a pro-cognitive effect of tianeptine in working memory compared to placebo.
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